Nurse prescribing: the New Zealand context

The purpose of this study was to examine the introduction of nurse prescribing in New Zealand, especially with respect to the basis of concerns related to level of knowledge and skills required of practitioners for safe prescribing; and further to compare experiences in New Zealand with those in other countries where nurses are authorised to prescribe. It is argued that prescribing rights previously extended to Nurse Practitioners and now being extended to other groups of nurses, and also to other health professions, is a matter provoking concern with respect to patient safety and adequacy of educational preparation. Unlike in the UK where extending prescribing rights to nurses did not involve rigorous educational preparation, Nurse Practitioners in New Zealand now undergo a stringent process involving Masters degree preparation in biological sciences and pharmacology (similar to USA). However, despite differences between policy environments, in New Zealand, criticisms grouped into concern about knowledge, patient safety and the impacts on team work and the health system echoed that voiced in the UK. The view that the educational model to prepare medical practitioners to prescribe is the 'gold standard' is critiqued and alternative models supported for extending prescribing rights to nurses and other professions. The expectation now is that extended prescribing rights are unlikely to be reversed. As the first two professions to be granted prescriptive authority in New Zealand, experiences in preparing both midwives and nurses educationally are expected to influence the models of educational preparation for other professions. The focus of the debate needs to shift from arguing against extending prescribing authority (especially to nurses), to consideration of how practitioners can be best prepared for and supported in the role.